Attachment II

COMMUNITY EVENT ORGANIZER APPLICATION

(*Submit 30 days in advance of the event)
*Application submitted less than 14 calendar days prior to the start of the event will be subjected to an expedited processing fee.

Name of Event: ___________________________________________________________ Date(s) of Event: _____________ to: _____________

Address of Event:___________________________________________________________ City: _____________________ Zip:__________
Event Organizer: ______________________________________ Time(s) of Event: _________ to: ___________ Set Up Time: _________
Person(s) in charge: ______________________________________________________________ Cell Phone: _______________________
Mailing Address: City: Zip:
Telephone: Fax: E-mail:

Event held in: Enclosed Building Open Field City Street Other:
All Permit(s) paid by Event Organizer in one payment TFF Permit(s) paid by individual operator

TEMPORARY FOOD FACILITIES (TFF) SITE PLAN NUMBER OF TFF PER TYPE
Submit a site plan showing the general layout of the event indicating Food Preparation:
location of the following: Pre-packaged w/ Sampling:
1. Food Booths/Food Trucks/Carts
2. Water Supply Food Demonstrator:
3. Toilet and Handwashing Facilities (quantity of each) Unpermitted Food Trucks/Carts:
4. Trash Disposal Containers (quantity)
5. Location of Shared Warewashing Facilities Subtotal:
6. Location of Animals, Rides, and Attractions Pre-packaged:
7. Janitorial Facilities LA County Permitted Food Trucks/Carts:
8. Backup Refrigeration (if provided)
Note: Include distances of toilet facilities and animals from foodbooths. Total TFF:

FOOD FACILITY PARTICIPANT LIST

FOOD BOOTHS

TEMPORARY FOOD FACILITY HANDWASHING SINK REQUIREMENTS

For specific events only, 5 gallons of warm water (100°F), soap, single-use towels in dispensers,
and a waste container available at each sink are required.
Handwashing facilities within each booth provided by: Event Organizer Temporary Food Facility Operator

Type of hand wash set up:

Portable Sink Gravity-fed unit (see page 9 of Health Code Requirements for TFFs) Permanently plumbed sink
 TEMPORARY FOOD FACILITY WAREWASHING SINKS
One warewashing sink may be shared by four TFFs if the sink is centrally located and is adjacent to the sharing facilities.
Based on the number and types of utensils, one warewashing sink may be shared by eight TFFs if it is easily accessible and within 100 feet of each TFF.

Warewashing facilities provided by: Event Organizer Temporary Food Facility Operator

Number of TFFs preparing foods: _______

NOTE: All warewashing sinks must
Number of three-compartment sinks provided with hot and cold running water: _______ have overhead protection in place.

Potable water source: Approved plumbing system

Reservoir Tanks: Volume of water per sink: _______

Method of liquid waste removal: Plumbed to the sewer line

Drained to a waste holding tank

Waste tank maintenance schedule: _________ times/day: _______ times/hour: _________________

Waste tank removal company information:

Company name:

Address:

Telephone:
*For a temporary food facility operating less than 4 hours, an adequate supply of spare utensils maybe provided in lieu of a warewashing sink.
The Event Organizer is required to have the emergency contact information for the liquid waste removal company.

FOOD HANDLER TOILET FACILITIES

One toilet is required per 15 food workers and must be located within 200 feet of all food facilities.
Handwashing facilities must be adjacent to toilet facilities.

Total number of food booth, truck, and cart workers: Number of toilets:

Distance from food booth(s) / food truck(s):

Number of handwashing sinks: (One handwashing sink for every toilet)

How are handwashing facilities supplied with warm & cold running water? Approved plumbing system Reservoir Tanks

PUBLIC TOILET FACILITIES

See chart on page 9 of Health Code Requirements for Community Events in LA County
Number of attendees anticipated during peak hours of operation: Number of toilets provided: _______

Number of handwashing sinks: __________ (At least one handwashing sink for every four toilets)

How are handwashing facilities supplied with running water? Approved plumbing system Reservoir tanks

For multi-day events, how often are toilets serviced? __________ times/day
 PORTABLE TOILETS
How often are portable toilets serviced (waste removal)? times/day

Portable toilet service company information:

Company name:

Address:

Telephone:

WASTE REMOVAL/DISPOSAL
All central refuse collection containers must have tight fitting lids.
Number of trash containers: How often are trash containers emptied? ________ times/day

Is there a central refuse collection site? Yes No Is there a secondary site? Yes No

If animal waste is present, how often is it removed? times/day times/hour

Trash / animal waste removal company information:

Company name:

Address:

Telephone:

ELECTRICAL POWER

No
Will electrical service be provided for night lighting or for overnight storage of refrigerated foods? Yes No

provide required information will delay or prevent approval of the event.

further legal action.

department and Alcoholic Beverage Control.

Date:

Signature:
 PARTICIPATING FOOD BOOTHS, FOOD TRUCKS, AND FOOD CARTS
Requires
Booth # on Permit or Vehicle # of Food
Business Name/DBA Owner's Name Telephone Warewash
Plot Plan License # Handlers Sink (Y or N)